Braiding and Blending of Funding

Issue brief developed in collaboration with the de Beaumont Foundation and the Association of State and Territorial Health Officials, which provides analysis and recommendations for states interested in coordinating services and resources across programs.

Issue brief highlights non-Medicaid funding sources that states could leverage through braiding or blending to better address social determinants or other needs that are not typically addressed by Medicaid.

Issue brief reviews several financing mechanisms for states considering greater health and human service integration, with a focus on Medicaid. Suggested models described range from one-time seed funding to broader braiding and blending strategies. The brief also summarizes ways that states can better encourage providers to incorporate social services into their care.

Integrating Services and Benefits

Issue brief developed in coordination with the Reforming States Group and the New York State Health Foundation, which provides a guide for states in understanding how to leverage current Medicaid flexibility to facilitate access to social services.

Issue brief describes three components that states must implement in order to integrate health and social services: a coordinating mechanism, appropriate quality measurement and data-sharing tools, and aligned financing and payment procedures.

Issue brief outlines currently flexibilities in the Medicaid program to support supportive housing services, and highlights three initiatives that target special populations including homeless individuals, people with disabilities, and adults with mental health and/or substance misuse disorders.

Report describes the way in which housing can impact social determinants, and current efforts and barriers to improving access to affordable, healthy housing for low income Americans. It additionally makes several recommendations, including to improve data collection and use, to improve budget and funding coordination, to allow for experimentation in models, and to strengthen housing and healthcare partnerships.

Report finds that in response to federal policy and new funding opportunities aimed at improving efficiency and effectiveness, states worked to strengthen connections between their health and human service programs through increased interoperability and systems integration. About two-thirds of states have integrated eligibility and enrollment systems shared by Medicaid and at least one human service program. Further, the report finds that data sharing across programs is common in most states but often only among programs in the same department or agency.

NGA convened a small group of state and local agency leaders, researchers and other experts to discussed the ways “in which shared data can enhance the effectiveness and efficiency of public programs – for example, by reducing the time and burden of separate intake and enrollment systems; helping agencies better understand client needs, develop appropriate solutions and document outcomes and facilitating research that can inform policy decisions.”

Issue brief notes that “among the most critical elements in providing better care for [complex care patients] are data. Before state leaders can begin to address their super-utilizer populations, they first need to understand who those patients are, how they use the health care system, and how the state might adapt its system to meet patient needs.”

A survey of 300 hospitals and health systems finds that providers are investing in health-related social needs, and that “80 percent of hospital respondents reported that leadership is committed to establishing and developing processes to systematically address social needs as part of clinical care.” Hospitals are increasingly screening patients and performing interventions, which may be spurred on through the shift towards value-based care.